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Paralysing post-ROSC patients prehospital

Advanced Paramedic Paralysis in ROSC (APPiR) study
British Paramedic Journal · 2026-09-01 · Added 29 August 2026

UK cohort of advanced paramedics in critical care giving neuromuscular blockade to post-ROSC patients poorly tolerating the tube — 99 patients over a year, all PGD indications met, with no adverse physiological trends in sats, end-tidal CO2, MAP or heart rate.

Study type

Cohort

Design

Retrospective cohort study

Participants

99 patients (85.9% male, mean age 57.6)

Main finding

All PGD indications were met; median time to NMB was 71 minutes from OHCA and 40 minutes post ROSC; all intubations within two attempts; no statistically significant adverse physiological trends.

Caveat

Small single-service descriptive cohort with no control group — safety signals are reassuring but say nothing about effect on outcomes.

Bottom line

Hypothesis-generating

Learning goal

Weigh the benefits and risks of prehospital neuromuscular blockade for post-ROSC patients before transport.

More

• Topic: Airway & ventilation
• Daily scan: 29 August 2026

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